Costa Rica is a country that tends to punch above its weight in health outcomes. With a life expectancy of more than 80 years and relatively low rates of smoking and alcohol consumption compared to much of the developed world, the country has long been held up as a model of efficient, effective public health.
But a detailed analysis published by the OECD paints a more complicated picture, one in which non-communicable diseases are quietly extracting an enormous toll on the country’s people, its health system, and its economy. Without serious intervention, the trajectory is getting worse rather than better.
Non-communicable diseases, or NCDs, are long-duration chronic conditions that develop slowly over time. They include cardiovascular diseases such as heart failure and stroke, cancers, chronic obstructive pulmonary disease, and diabetes. Globally, they are the leading cause of death, and Costa Rica is no exception. According to the OECD report, 30% of all premature deaths in the country, defined as deaths before age 75, are attributable to these four disease categories.
Cancer alone accounts for 15% of premature deaths, followed by cardiovascular disease at 11%, COPD at 2%, and diabetes at 1%. Men bear a disproportionate share of the burden, dying prematurely from NCDs at a rate of 95 per 100,000 compared to 68 per 100,000 for women.
The first major takeaway from the report is that the NCD crisis in Costa Rica is growing, and risk factors are moving in the wrong direction. Despite Costa Rica’s strong performance on smoking, with only 5.6% of the population smoking daily compared to an OECD average of 15.1%, and on alcohol, where consumption is less than half the OECD average, other risk factors have deteriorated significantly since 2010.
Rising obesity rates, insufficient physical activity, and air pollution have pushed the number of new NCD cases upward. The OECD’s modeling projects that, even if nothing else changes from this point forward, meaning the same risk factor levels, the same survival rates, and the same population size, Costa Rica will see a 55% increase in total NCD cases by 2050, a 128% increase in people living with at least two concurrent NCDs, and a 102% increase in per capita health spending on these diseases. The compounding effect of an aging population will only accelerate this trend.
The second major takeaway is the staggering economic cost that NCDs impose, along with the significant gains that addressing them could bring. The OECD calculates that if the four main NCDs were eliminated entirely, Costa Rica’s total health expenditure would be 29% lower on average between 2026 and 2050.
The workforce would effectively gain the equivalent of nearly 58,000 additional full-time workers, as reduced absenteeism and presenteeism restore productivity now lost to chronic illness. At the macroeconomic level, eliminating NCDs would deliver an average annual GDP boost of 3.3%, a figure that shows how deeply chronic disease is already dragging on the country’s growth potential.
The third, and perhaps most actionable, takeaway is that a relatively small number of targeted interventions could capture most of these benefits. The OECD analysis identifies obesity, air pollution, and physical inactivity as the three priority risk factors for Costa Rica. Together, tackling just these three by aligning their prevalence with the levels achieved by the top quarter of OECD and EU countries would prevent 94% of the avoidable new NCD cases, reduce premature mortality by 94% of what full intervention across all risk factors would achieve, and deliver 98% of the potential GDP gain.
Obesity alone is the single most impactful target, accounting for 53% of all new cases that could be avoided, 72% of the reduction in premature deaths, and 79% of the economic gains. The report also makes clear that prevention is far more powerful than treatment. Reducing obesity prevalence to top-quartile levels would have more than 16 times the GDP impact of improving cardiovascular disease survival rates.
Costa Rica stands at a crossroads. The same social fabric and institutional strengths that have made it a health leader in Latin America could, with deliberate policy focus on obesity, air quality, and physical activity, allow it to bend the curve on NCDs before the costs become unmanageable.
